EMMR Membership Form
(Use your browser's Print button to print this form, complete it and send by US Mail.)

 

Name: ___________________________

Address: _______________________________________

City: ___________________________

State: ______

Zip: ____________________

Telephone: ___________________

Spouse's Name: ___________________________

Building Fund Contribution: _______________

Annual Membership Fee: $20.00

Lifetime Membership Fee: $200.00

Total Enclosed: ______________

Mail to:

    EMMR
    PO Box 688
    Mechanicsburg, PA 17055

Checks payable to: EMMR

www.emmr.org